Getting Things Done in a Post-socialist Hospital: Non-monetary Informal Practices

• In Event: 322 - Section on Medical Sociology Roundtable Session
  In Refereed Roundtable: Table 02. Healthcare Professionals

Abstract

This paper contributes to the scholarship on the mobilization of personal connections for securing preferential treatment and other privileges (blat, in Russia; guanxi, in China) by examining two practices encountered in the emergency ward of a public hospital in Romania: informal referral of patients and falsification of electronic registry entries. Informal referral is the practice of introducing a patient as a personal connection by a member of the hospital staff with the expectation, overtly stated or not, of gaining favorable handling. Falsification of electronic registry entries refers to the manipulation of data pertaining to the admission and discharge of patients so that it fits the perceived expectations of officials monitoring the registry. Based on 4 months of ethnographic fieldwork (March-June 2013) in a county hospital, the study focuses on the practical accomplishment of the departures from official norms and procedures. Particular attention is paid to the neutralization maneuvers employed by participants to the encounter to minimize moral accountability for their involvement: downplaying the importance of the practice; embedding it into socially legitimate phenomena, such as helping friends; framing it as a formal practice; and creating ambiguous definitions of the situation. The paper makes the point that informal referrals and manipulations of the registry entries are part of the socialist hysteresis, being originated in the double standards (official and habitual) that used to regulate everyday activities at all levels, including the provision of public services.

Author

• Marius Wamsiedel, University of Hong Kong